Individual
ALYSSA M LONERGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1055 WESTGATE DR, SAINT PAUL, MN 55114-1065
(651) 635-9173
Mailing address
1055 WESTGATE DR, SAINT PAUL, MN 55114-1065
(651) 635-9173
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
12910-24
WI
225100000X
Physical Therapist
Primary
9046
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12910-24
STATE LICENSE
MN
Enumeration date
11/16/2016
Last updated
08/15/2019
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